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Organization
KUSH MEDICAL GROUP
Active
Organization
KUSH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIANSI BONI MD (OWNER)
(310) 644-3488
Entity
Organization
Contact information
Practice address
14015 VAN NESS AVE # 10, GARDENA, CA 90249-2937
(310) 327-7682
(310) 327-7765
Mailing address
PO BOX 6299, TORRANCE, CA 90504-0299
(310) 327-7682
(310) 327-7765
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
A45536
CA
207Q00000X
Family Medicine Physician
A45536
CA
208000000X
Pediatrics Physician
A45536
CA
208VP0014X
Interventional Pain Medicine Physician
A45536
CA
Other
Enumeration date
03/10/2007
Last updated
09/11/2025
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